Provider Demographics
NPI:1477506111
Name:HOLLIS, ROBERT F III (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:F
Last Name:HOLLIS
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ROBERT
Other - Middle Name:F
Other - Last Name:HOLLIS
Other - Suffix:III
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1818 CHAPEL DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-1335
Mailing Address - Country:US
Mailing Address - Phone:419-420-7304
Mailing Address - Fax:419-420-7317
Practice Address - Street 1:1818 CHAPEL DR
Practice Address - Street 2:SUITE C
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-1335
Practice Address - Country:US
Practice Address - Phone:419-420-7304
Practice Address - Fax:419-420-7317
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT8505207T00000X
OH35120685207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT12325Medicaid
MT18161OtherBLUE CROSS
MT10001816Medicare ID - Type Unspecified
MT18161OtherBLUE CROSS